Department of Internal Medicine I, University of Bonn, Bonn, Germany.
Institute of Experimental Immunology, University of Bonn, Bonn, Germany.
Nephrology (Carlton). 2023 Jan;28(1):51-59. doi: 10.1111/nep.14131. Epub 2022 Nov 21.
Beta Trace Protein (BTP) is a biomarker for residual kidney function which has been linked to cardiovascular and all-cause mortality in haemodialysis patients. Following renal transplantation, recipients remain at increased risk for cardiovascular events compared with the general population. We aimed to determine the relationship of pre-transplant BTP to major adverse cardiac events (MACE) in patients following kidney transplantation.
We included 384 patients with end-stage renal disease who received a kidney transplant. MACE was defined as myocardial infarction (ST-segment elevation or non-ST-segment elevation, stroke or transient ischemic attack), coronary artery disease requiring intervention or bypass or death for cardiovascular reason. The association between pre-transplant serum BTP concentration and post-transplant MACE was evaluated by Kaplan-Meier and Cox regression analyses.
Post-transplant MACE occurred in 70/384 patients. Pre-transplant BTP was significantly higher in patients with post-transplant MACE (14.36 ± 5.73 mg/l vs. 11.26 ± 5.11 mg/l; p < .01). Next to smoking (HR 1.81), age > 56.38 years (HR 1.97) and pre-existing coronary heart disease (HR 8.23), BTP above the cut off value of 12.7 mg/l was confirmed as independent risk factor for MACE (HR 2.02, all p < .05). MACE-free survival inversely correlated with pre-transplant BTP levels.
Pre-transplant serum BTP concentration may identify renal transplant recipients with higher risk of post-transplant MACE.
β痕迹蛋白（BTP）是一种与血液透析患者心血管和全因死亡率相关的残余肾功能生物标志物。肾移植后，与普通人群相比，受者仍面临更高的心血管事件风险。我们旨在确定移植前 BTP 与肾移植后患者主要不良心脏事件（MACE）的关系。
我们纳入了 384 名终末期肾病患者，他们接受了肾移植。MACE 定义为心肌梗死（ST 段抬高或非 ST 段抬高、中风或短暂性脑缺血发作）、需要介入或旁路治疗的冠状动脉疾病或心血管原因导致的死亡。通过 Kaplan-Meier 和 Cox 回归分析评估移植前血清 BTP 浓度与移植后 MACE 之间的关系。
384 例患者中有 70 例发生移植后 MACE。发生移植后 MACE 的患者移植前 BTP 明显较高（14.36±5.73mg/l 比 11.26±5.11mg/l；p<0.01）。除了吸烟（HR 1.81）、年龄>56.38 岁（HR 1.97）和预先存在的冠心病（HR 8.23）外，BTP 高于 12.7mg/l 的截断值被确认为 MACE 的独立危险因素（HR 2.02，均 p<0.05）。MACE 无事件生存率与移植前 BTP 水平呈负相关。
移植前血清 BTP 浓度可识别移植后发生 MACE 风险较高的肾移植受者。
